Persistent mercury hot spot in Central Europe and Skalka Dam reservoir as a long-term mercury trap.

This study aimed to evaluate the relevance of the floodplain pollution sinks of the legacy mercury (Hg) hot spot in Kössein-Röslau river system (east Bavaria, Germany) for further mobilisation and fluvial transport of mercury in suspended particulate matter (SPM), as an important transport medium of Hg in aquatic systems. The channel belt fluvial erosion as the secondary pollution pathway was also considered. The hot spot has originated from the production of Hg compounds such as C2H5HgCN and C6H5HgCl in Chemical Factory Marktredwitz, and even more than 30 years after the factory abandonment, the Kössein and the Röslau rivers still export polluted fine grained SPM (median 25-35 µm) with mean annual concentrations of 17.4 mg/kg. SPM sampling was performed by floating samplers, supported by floodplain drill cores and by recent channel sediments manually collected along the polluted rivers further. Based on long-term monitoring data set from state enterprise Povodí Ohre, fish in the Skalka Reservoir have had Hg concentrations in their muscles up to 6 mg/kg for at least the last 14 years, exceeding the European maximal limit of 0.5 mg/Hg/kg. In addition, the Hg inventory in the Kössein-Röslau river stretches was therefore calculated; it produced an estimate of ca. 21 t Hg in a 22-km-long channel belt, prone to fluvial remobilisation during floods. Although a major portion of the fluvially transported Hg has yet been trapped by the Skalka Reservoir, the Hg content in the SPM exported farther downstream still varies between 2 and 10 mg/kg Hg. Due to the considerable Hg inventory in the Kössein-Röslau rivers, an improvement will not occur downstream unless specific measures target the secondary pollution mechanism(s).

Comparison of the efficacy and safety of high doses of beclometasone dipropionate suspension for nebulization and beclometasone dipropionate via a metered-dose inhaler in steroid-dependent adults with moderate to severe asthma.

Nebulization for the administration of high doses of inhaled corticosteroids can benefit steroid-dependent asthmatics. The objective of this double-blind, double-dummy, multicentre, randomized, parallel-group study was to compare the efficacy and safety of high-dose corticosteroids given by nebulization or metered-dose inhalation in adult patients with asthma. Following a 2-week run-in period, 124 patients, aged 18-70 years, with moderate to severe asthma treated with high-dose inhaled steroids were randomized to one of two treatment groups for 12 weeks: beclometasone dipropionate (BDP) suspension for nebulization 3,000-4,000 microgday(-1) b.i.d. given via a nebulizer (n = 63), or BDP spray 1,500-2000 microgday(-1) b.i.d. given via a metered-dose inhaler (MDI) plus spacer (BDP MDI) (n = 61). Comparable improvements over baseline, which were statistically significant in most cases, were reported at study end for the two treatment groups in the various efficacy parameters evaluated (pulmonary function tests, clinical symptoms scores, and the use of rescue salbutamol). The primary efficacy endpoint was morning pulmonary expiratory flow rate (PEFR). For the intent-to-treat population, in the BDP nebulization group mean morning PEFR increased statistically significantly from 308.7 +/- 107.81 min(-1) to 3 19.2 +/- 104.01 min(-1) while in the BDP MDI group the increase was from 301.5 +/- 94.71 min(-1) to 309.3 +/- 86.71 min(-1). The two treatments were equally well tolerated.A total of 19 patients in each group reported adverse events during the treatment period, and these were generally mild-moderate in severity. In conclusion, the results of this study demonstrate that BDP suspension for nebulization 3,000-4,000 microg day(-1) given via a nebulizer and BDP spray 1,500-2,000 microg day(-1) given via an MDI plus spacer are equally effective, with an acceptable safety and tolerability profile, when used in steroid-dependent adult patients with moderate to severe asthma.

[QT dispersion in DDD and VVI paced patients after myocardial infarction or with left ventricular hypertrophy]. / Dyspersja odstepu QT w dlugotrwalej stymulacji dwujamowej typu DDD i komorowej VVI u chorych po zawale miesnia serca lub z jego przerostem.

The aim of this study was to assess the alterations of stroke volume (SV) on the QT dispersion (QTD) as a result of different pacing modes and programmed AV delays in patients (pts) after myocardial infarction (MI) or with left ventricular hypertrophy (LVH). We studied 14 MI pts (9 M, 5 F) in mean age 72.3 +/- 3.7 yrs (Group I) and 12 pts with LVH (7 M, 5 F) in mean age 67.3 +/- 5.9 yrs (Group II), in whom DDD pacemakers were implanted due to complete atrioventricular block. The control group (Group III) consisted of 9 pts without MI or LVH. In all cases basic rate of the pacemaker was programmed at 70/min. Resting ECG showed all atrial and ventricular complexes captured. AV delay optimization was based on the measurements of SV by Doppler echocardiography. QT intervals (QTi) were measured from 12-lead ECG at 50 mm/s speed. QTD was calculated as the difference between maximal and minimal QTi. It was measured at optimal (opt. DDD, with highest SV) and "unoptimal" (unopt. DDD) programmed AV intervals and then in VVI mode (with lowest SV) after following reprogramming of the pacemaker. In Group I and II, a strong correlation between SV and QTD was found (R = 0.816 and -0.897, respectively). In control group, it was insignificant (R = -0.339). In VVI mode SV was significantly lower than in unopt. DDD (in Mi pts: 56.1 ml vs 71.1 ml, respectively, p < 0.01; in LVH pts: 64.1 ml vs 96.7 ml, respectively, p < 0.005) and QTD was significantly greater (74.8 ms vs 66.8 ms, respectively, p < 0.005 and 70.0 ms vs 53.5 ms, respectively, p < 0.005). In LVH pts or MI pts programming of different AV intervals and pacing modes significantly influences QTD.

Enhanced lipid peroxidation in cancer tissue homogenates in non-small cell lung cancer.

The oxidative modification of nucleic acids by reactive oxygen species may lead to malignant conversion, but its exact role in lung cancer biology is still not clear. Lipid peroxidation, a well-known index of free radicals activity, is a process of oxidative polyunsaturated acids destruction. Our study was aimed to investigate the level of lipid peroxidation ex vivo in tumor tissue and lung parenchyma obtained from patients with non-small cell lung cancer. Thirty-two patients with lung cancer (including 19 with squamous cell lung cancer) were enrolled in the study. During a surgical resection, tumor tissue and lung parenchyma were obtained and the concentration of lipid peroxidation products, i.e. conjugated dienes and lipid hydroperoxides, measured. In the whole group of patients the concentrations of conjugated dienes and lipid hydroperoxides in the tumor tissue were higher than those in lung parenchyma (1.008 +/- 0.503 A233 nm vs. 0.717 +/- 0.283 A233 nm; p < 0.05 and 0.109 +/- 0.062 A532 nm vs. 0.102 +/- 0.087 A532 nm; p < 0.05, respectively). Similar results were obtained in squamous cell carcinoma patients (0.975 +/- 0.348 A233 nm vs. 0.708 +/- 0.300 A233 nm; p > 0.02 and 0.094 +/- 0.029 A532 nm vs. 0.080 +/- 0.071 A532 nm; p < 0.05, respectively). In both groups of patients, a positive correlation between concentration of conjugated dienes in tumor tissue and clinical stage (R = 0.45; R = 0.52; p < 0.05, respectively) was found. Our results confirm the enhanced lipid peroxidation in cancer tissue as compared with matched lung parenchyma. Additionally, a higher level of oxidative stress, expressed as the concentration of conjugated dienes in tumor tissue, was associated with clinical progression of the tumor.

[The evaluation of efficacy and tolerability of salbutamol administered by nebulization in patients with stable severe bronchial asthma]. / Ocena skutecznosci i tolerancji Salbutamolu w nebulizacji u chorych na stabilna ciezka astme oskrzelowa.

The aim of the study was the assessment of the effect of salbutamol in nebulization on ventilatory parameters and heart action in patients with stable severe well controlled bronchial asthma. The study was performed in 30 asthmatics (19 females and 11 men) with incomplete reversibility of airflow obstruction after salbutamol inhalation administered via MDI device. The mean age was 47 years, the duration of asthma--18 years. Mean FVC value was 2.46 L (66.6%), FEV1--1.76 L (56.8%), and MEF50--1.74 L/s (40.4% predicted). The study was performed according to the double-blind crossover method with placebo used. On the first day the reversibility test with 400 mg salbutamol was performed. On the two consecutive days salbutamol (Steri-Neb Salamol 2.5 mg) and placebo in nebulization were randomly administered. Ventilatory parameters were measured before and in 20, 40, 60, 120, 180 and 240 minutes after the nebulization. At the same time points the heart action was assessed by physical examination. The changes in FVC, FEV1 and MEF50 were expressed in absolute values and as a relative increase in relation to predictive value. The significant improvement of measured ventilatory parameters was observed as early as 20 minute after the nebulization. This increase in MEF50 lasted 2 hours, in FEV1--3 hours and in FVC 4 hours. The relative increase in MEF50 was significant higher than the remaining parameters. The significant increase in heart rate was noted after salbutamol nebulization.

[The effect of changes in stroke volume on QT dispersion during long-term DDD and VVI pacing]. / Wplyw zmian rzutu skurczowego na dyspersje odstepu QT w przewleklej stymulacji DDD i VVI.

UNLABELLED: The aim of this study was to evaluate the alterations of stroke volume (SV) on the QT dispersion (QTD) as a result of different pacing modes (DDD, VVI) and programmed AV delays (AVD). MATERIAL AND METHODS: We studied 60 patients (pts) (22 F, 38 M) in mean age 67.5 +/- 7.5 yrs in whom DDD pacemakers were implanted due to complete atrioventricular block (AVB III degree). 10 pts had coronary artery disease (CAD)--"CAD" subgroup, 14 pts arterial hypertension (AH)--"AH" subgroup, 27 pts CAD and AH--"AH + CAD" subgroup. The control group consisted of 9 pts without structural heart disease, but with AVB III degree, paced in DDD mode. Previous myocardial infarction was recognised in 7 patients in "CAD" subgroup and in 7 patients in "AH + CAD" subgroup. Left ventricular hypertrophy was detected in 4 men in "AH" subgroup and in 8 patients in "AH + CAD" subgroup. In all cases basic rate of the pacemaker was programmed at 70/min. Resting ECG showed all atrial and ventricular complexes captured. AVD optimization was based on the measurements of SV by Doppler echocardiography. QT intervals (QT) were measured from 12-lead ECG at 50 mm/sec. speed. QTD was calculated as the difference between maximal and minimal QT. It was measured at optimal AVD (with highest SV--opt. DDD) and "unoptimal" AVD (unopt. DDD) programmed AV intervals and then in VVI mode (with lowest SV) after 24 hrs following reprogramming of the pacemaker. RESULTS: In the whole population, in DDD mode, we found a strong correlation between SV and QTD (r = -0.655; p < 0.01). In VVI mode SV was significantly lower than in unopt. DDD (78.7 ml vs 90.0 ml, p < 0.001) and QTD was significantly greater (74.3 ms vs 69.2 ms, p < 0.05). The modifications in AVD and conversion of pacing mode (VVI to DDD) leading to maximal SV resulted in decreased QT dispersion. The highest SV (128.9 ml at opt. DDD) and the lowest QTD (48.3 ms at opt. DDD) were seen in the controls, but changes in dispersion were the least and insignificant during different pacing modes. In CAD; AH + CAD pts, we observed the lowest SV (61.7 ml; 74.9 ml at VVI respectively) and the highest QTD (77.8 ms; 80.9 ms at VVI respectively). In these pts, the modifications of AVD and conversion of pacing mode (VVI to opt. DDD) leading to maximal SV (106.8 ml; 115.9 ml in CAD and AH + CAD pts, respectively) resulted in decreased QTD (53.9 ms; 56.6 ms, respectively). During DDD pacing there was significant correlation of QTD to SV (r = -0.680; r = -0.656, respectively). In CAD pts with myocardial infarction or in AH pts with LV hypertrophy the correlation of SV to QTD was stronger (r = -0.937, r = -0.886, p < 0.025, respectively). We didn't find the correlation in the control group (r = -0.318). CONCLUSIONS: Programming of different AVD and pacing modes significantly influences QTD in CAD and/or AH pts. QTD reflects hemodynamic status of these paced pts.

[Evaluation of the relationship between the clinical course of severe asthma and ventilatory parameters]. / Ocena zwiazków miedzy klinicznym przebiegiem ciezkiej astmy oskrzelowej a wskaznikiem wentylacji.

The aim of the study was the assessement of relations between the clinical symptoms of asthma, ventilatory parameters and nonspecific bronchial hyperresponsiveness. 22 patients with severe asthma, 12 females and 10 men, aged 43-68 years (mean 56) were observed for two years. The duration of asthma ranged from 6 to 38 years (mean 18). All the patients were treated with inhalatory steroids in dose 800-1200 mg. Three months before entering the study the patients had no exacerbation or respiratory tract infection. Throughout the study diary cards were filled and the symptoms were recorded on 0-4 scale. PEF was measured two times a day, the highest value noted. Spirometry and reversibility tests were performed. On the last day patients underwent histamine challenge test. Data from four weeks were analyzed statistically. The significant correlation was established between PEF variability and clinical symptoms scores, both mean and measured in the last day of the study. The relationship between mean PEF variability and bronchial hyperresponsiveness was also observed.

[The influence of salmeterol and salbutamol on bronchial constriction in patients with bronchial asthma]. / Wplyw salmeterolu i salbutamolu na zwezenie oskrzeli u chorych na astme oskrzelowa.

The aim of the study was to compare bronchodilatating effect of inhaled salmeterol, salbutamol and both drugs administered simultaneously. 14 subjects (7 females, 7 men), aged 30-65 years (mean 49 yrs), suffering from moderate to severe asthma were examined. The improvement of FEV1 greater than 15% within 15 minutes of inhaling 200 micrograms of salbutamol was demanded. The study was performed in randomized, double-blinded, placebo controlled design. Throughout the study, all patients kept a daily score of symptoms and treatment. Each day of the trial, FEV1 in 30, 60, 120, 180 and 240 minute was measured. The statistically significant increase of FEV1 was noted only in 30 minute after salbutamol and in 180 minute after inhaling of salmeterol in comparison to salbutamol alone. No significant advantage of adding salbutamol to the patients previously treated with salmeterol was observed.

[Nonspecific bronchial hyperreactivity in patients with seasonal bronchial asthma observed through two consecutive years]. / Nieswoista nadreaktywnosc oskrzeli u chorych na sezonowa astme oskrzelowa obserwowanych przez dwa kolejne lata.

Seasonal bronchial asthma causally connected with the exposure to pollen allergens is a chronic, eosinophilic mucosal inflammation of airway. This inflammation is the basis for the development of nonspecific bronchial hyperreactivity which is the most typical but mutable feature of asthma. Bronchial hyperreactivity often determines asthma intensity and the need of asthma treatment. The nonspecific bronchial hyperreactivity over two consecutive years was evaluated in 11 patients (2 women and 9 men) with seasonal bronchial asthma, sensitized to grass, remaining under the conditions of natural allergen exposure and out of this period. Bronchial reactivity to histamine was measured by Cockcroft's at all method. So called histamine threshold (PC20H) in mg/ml was assessed. The values of ventilatory parameters (FVC, FEV1) and asthma symptom scores were also measured. It was showed that nonspecific bronchial hyperreactivity significantly increased in subjects with seasonal bronchial asthma during natural pollen exposure. PC20H in two studies performed during this period decreased 3 and 6 times when compared to preseasonal values. The majority part of patients (80%) has the increased bronchial reactivity to histamine also beyond the of grass season when clinical symptoms of asthma and rhinitis are not observed. This postseasonal hyperreactivity could be the effect of the chronic inflammation process persisted from the period of natural allergen exposure. Continuous subthreshold, which means asymptomatic exposure to perennial allergens to which most of patients are sensitized, could be another reason of this hyperreastivity. The possibility of exposure to the activity of seasonal allergens the whole year in persons with asthma can not omitted, as the presence of pollens in the sample of the house dust in patient's flat is observed during the yield of pollen season. Nonspecific bronchial hyperreactivity in individual patients is fluctuated, which probably is not dependent on the intensity of natural allergen exposure.

Persistent expression of a soluble form of Fas/APO1 in continuously activated T cells from a patient with SLE.

OBJECTIVE: To report a patient with SLE whose T cells expressed disproportionally increased amounts of an alternatively spliced form of Fas/APO1 transcript and secreted a soluble form of Fas. METHODS: We established continuously activated, short-term T cell lines from 16 patients with SLE and from 6 normal controls. The structure, expression and function of Fas was examined using RT-PCR and sequencing, flow cytometry (surface expression of Fas), ELISA (measurement of soluble Fas) and a PI-based cytotoxicity assay (functional analysis). RESULTS: A soluble form of Fas which originates from an alternatively spliced transcript and lacks the transmembrane domain of the original molecule was the dominant product of the Fas-gene in one line (S18B) derived from a patient with very active SLE. Compared to a control line, the S18B cells displayed decreased surface Fas expression but increased accumulation of Fas inside the cell. The amount of soluble Fas in the culture supernatant of S18B was found to be 1.8 times higher than that of a control line. Culture supernatants from S18B cells inhibited anti-Fas mAb-medicated T cell death. CONCLUSION: Continuously activated T cells from one patient with SLE displayed increased amounts of soluble Fas that inhibits anti-Fas mediated cell death. Although the frequency of this abnormality among patients with SLE and other diseases is unknown, increased production of soluble Fas may have contributed to the pathogenesis of SLE in the patient presented here.

[The influence of multiple histamine inhalation on nonspecific airway hyperresponsiveness to histamine in patients with bronchial asthma]. / Wplyw wielokrotnego wziewania histaminy na nieswoista nadreaktywnosc oskrzeli na histamine u chorych na astme oskrzelowa.

The study was performed in 19 patients with stable mild/moderate asthma aged from 16 to 66. Nonspecific airway hyperresponsiveness (AH) to histamine was measured according to Cockcroft's et al. method and expresses as PC20H in mg/ml. The study was controlled by inhalation of PBS. The histamine or PBS challenges were performed three times at 45 min. intervals on the third day in case when the stability of AH on two preceding days was observed. The geometric means of PC20H (xg PC20H) during the consecutive three days did not change. They were 0.97, 0.92, 0.87 mg/ml (p > 0.05) respectively. Three times histamine challenges performed on the same day induced the decrease of AH (xg PC20H increased from 1.48 to 6.55 mg/ml) in 5 patients. In 4 other subjects the increase of AH was observed (xg PC20H decreased from 1.14 to 0.20 mg/ml). In 10 subjects the three times histamine challenges performed on the same day had no influence on AH to histamine.

[An increase of nonspecific airway hyperreactivity after repeated challenge with subthreshold doses of allergen in asthma patients]. / Wzrost nieswoistej nadreaktywnosci oskrzeli po wielokrotnej prowokacji podprogowa dawka alergenu u chorych na atopowa astme oskrzelowa.

The study was performed in 11 patients suffering from stable mild and moderate atopic asthma. Bronchial allergen challenges were performed according to Chai et al method. Airway hyperreactivity-AH (PC20H in mg/ml) was determined in each study day before subthreshold allergen inhalation dose, meaning the dose which did not induce asthmatic responses. Then FEV1 was measured in 2, 5, 15, 30 i 60 min. after allergen provocation throughout 4 to 9 consecutive days. A significant increase of PC20H was observed in 8 patients (xg PC20H in whole group decreased from 0.93 to 0.35 mg/ml after allergen challenges). The authors conclude that allergen inhalation challenge without asthmatic bronchial responses can cause an increase AH.

[The effect of nedocromil sodium on the clinical course, ventilatory parameters and nonspecific bronchial hyperreactivity in patients with nonatopic bronchial asthma treated with beclomethasone dipropionate]. / Wplyw nedokromilu sodu na przebieg kliniczny, wskazniki wentylacyjne i nieswoista nadreaktywnosc oskrzeli u chorych na astme nieatopowa leczonych beklometazonem.

The efficacy of nedocromil sodium (NED) (8mg twice daily) in controlling the clinical symptoms of asthma (score symptoms), the pulmonary parameters (FEV1, FVC) and bronchial hyperreactivity to histamine was assessed. The study was performed in double-blind, cross-over and placebo-controlled way in 16 patients suffering from nonatopic, stable, moderate asthma treated with beclomethasone dipropionate (from 400 micrograms to 800 micrograms). NED and placebo were administered in a randomized way with 8-week wash-out period. Bronchial reactivity to histamine, was measured as the amount of histamine causing a 20% fall in FEV1 (PC20H in mg/ml). Treatment with NED did not change asthma symptom scores, FVC and FEV1. Decreased usage of beta 2-agonist was observed. NED did not influence bronchial hyperreactivity to histamine (xg PC20H was respectively 0.09 and 0.11 mg/ml after placebo and 0.06 and 0.08 after NED). The authors conclude that studies with NED in nonatopic asthmatics should be continued, but the dosage of the drug ought to be bigger and the time of treatment ought to be longer.

[The effect of nedocromil sodium on spontaneous production of histamine releasing factor (HRF) by mononuclear blood cells in patients with nonatopic bronchial asthma]. / Wplyw nedokromilu sodu na samoistne wytwarzanie, przez komórki jednojadrowe krwi obwodowej, czynnika uwalniajacego histamine z bazofili (HRF) u chorych na nieatopowa astme oskrzelowa.

The aim of the study was to evaluate the effect of 28-days antiinflammatory treatment with nedocromil sodium (Ned.sod.) (Tilade-8 mg/24 hours) on nonspecific bronchial hyperreactivity (PC20H in mg/ml) and spontaneous HRF activity production by mononuclear blood cells in patients with nonatopic bronchial asthma treated with beclomethasone dipropionate. The correlation between PC20H and HRF was also examined. The study was performed in 10 subjects with mild and moderate chronic, stable asthma in a double-blind, placebo-controlled way. Placebo and Ned. sod were given through 4 weeks in a randomized way with 8 weeks wash-out period. It was shown that Ned. sod. did not influence clinical asthma symptom scores, ventilatory parameters and PC20H. No changes in the spontaneous production of HRF activity were observed. The correlation between HRF activity and PC20H assessed 4 times was not significant. The authors conclude that studies with Ned. sod. in nonatopic asthma should be continued, but the dosage of the drug ought to be bigger and the time of treatment should to be longer.

[Chemotactic serum activity for neutrophils and eosinophils and spontaneous production of histamine releasing factor in patients with seasonal bronchial asthma treated with nedocromil sodium]. / Aktywnosc chemotaktyczna surowicy dla neutrofili i eozynofili oraz samoistna produkcja przez komórki jednojadrowe krwi obwodowej czynnika uwalniajacego histamine u chorych na sezonowa astme oskrzelowa leczonych nedokromilem sodu.

Nedocromil sodium (NS- Tilade) is an effective therapeutic agent against asthma and has been shown to exhibit antiinflammatory activity in vitro. The aim of this study was to assess the effect of NS on the serum neutrophil (NCA) and eosinophil (ECA) chemotactic activity and mononuclear cells-derived histamine releasing factor (HRF) activity in 14 patients with seasonal allergic asthma. The chemotactic activities, HRF and bronchial reactivity to histamine (PC20H in mg/ml) were determined before the grass-pollen season and at the end of the 14-day placebo treatment and 21-day NS treatment during the pollen-season. NCA and ECA were assessed using of the Boyden chamber methods. Blood samples for mononuclear cells culture were collected during the trial. The supernatants were assayed for HRF activity with basophils from a single donor. The NCA index was unaltered during the trial. There was a significant (p < 0.05) increase in the ECA after the NS treatment period (ECA index--2.5) compared with out of season and after placebo treatment (ECA index, 1.88 and 1.82). HRF activity increased after placebo compared with out of season (HRF % activity--38.62 before season, 47.61 after placebo p < 0.05) but NS did not revealed the further effect on HRF activity (49.81 p > 0.05). During placebo the significant decrease in PC20H from 1.81 mg/ml to 0.54 mg/ml (p < 0.05) was observed. NS did not have the effect on nonspecific bronchial reactivity--PC20H--0.74 mg/ml (p > 0.05). The correlation between PC20H and spontaneous production of HRF activity was not found. The results indicate that NS has some effect on inflammatory process which takes place in seasonal asthmatic patients during the natural allergic exposure.

[Bronchial hyperresponsiveness in patients with seasonal allergic rhinitis and the influence of loratadine and beclomethasone on this hyperresponsiveness]. / Wystepowanie nieswoistej nadreaktywnosci oskrzeli u chorych na sezonowy alergiczny neizyt nosa oraz wplyw loratadyny i beklometazonu na te nadreaktywnosc.

60 patients aged 16 to 46 years with seasonal allergic rhinitis were selected for study. Daily symptom scores of seasonal allergic rhinitis and nonspecific bronchial hyperresponsiveness to histamine (PC20H in mg/ml) before, during the pollen season and after 3 weeks of treatment with loratadine, beclomethasone dipropionate were evaluated. The control group received oxymetazoline. Nonspecific bronchial hyperresponsiveness for 11 patients (18.3%) before the seasons was observed. At the beginning of the season frequency of nonspecific bronchial hyperresponsiveness increased to 26.3% and to 36.8% after 3-week treatment course. Bronchial hyperresponsiveness was not related to any of the way of treatment. The patients treated with beclomethasone dipropionate and oxymetazoline showed significant relief of nasal symptoms. The patients without bronchial hyperresponsiveness showed lower value of symptom scores.

[The role of prolonged cardiac pacing in management of secondary bradyarrhythmias based on personal experiences]. / Miejsce przewleklej stymulacji elektrycznej serca w leczeniu wtórnych bradyarytmii na podstawie wlasnych spostrzezen.

Three patients with bradyarrhythmia who were admitted to the Department for urgent pacemaker implantations are presented. The careful clinical evaluation revealed that these arrhythmias were remarkably secondary to underlying diseases (e.g. severe coronary heart disease, valvular defects). Surgical treatment applied in these cases (coronary bypass grafts, valve replacement) has resulted in successful outcome. We concluded that in some patients the pacemaker implantation alone, without heart surgery, would not be beneficial enough.

[Effect of nedocromil sodium on clinical course and histamine airway responsiveness in patients with pollen induced bronchial asthma]. / Wplyw nedokromilu sodu na przebieg kliniczny i nieswoista reaktywnosc oskrzeli na histamine u chorych na pylkowa astme oskrzelowa.

Nedocromil sodium is a non-steroidal prophylactic agent for the management of asthma. We assessed the effect of inhaled of nedocromil sodium 8 mg/24 h in a double blind, placebo controlled study in 14 patients suffering from seasonal (grass-pollen) asthma. Symptom scores for dyspnoe, cough, rhinitis and airway responsiveness to histamine (PC20H) according to Cockcroft et al were estimated before the grass-pollen season and at the end of 14-day placebo treatment and 21-day nedocromil sodium treatment. During placebo period the significant decrease in PC20H from 1.81 mg/ml to 0.54 mg/ml (p < 0.01) was observed. Nedocromil sodium did not have the effect on nonspecific bronchial responsiveness, PC20 - 0.74 mg/ml (p = 0.25). Subjective global assessment scores were significantly better with nedocromil sodium (31.15 mean 2.23) than with placebo (10.5 mean 0.7) p < 0.05.